Dec 2011 VSG's since we have something in common...
I'm In. Supposed to be sleeved 12/5. Not really scared or nervous. I usually don't get that way until about 10 minutes before any procedure. (blood draw etc. I hate needles)
1st Goal 225 2nd Goal 200 3rd Goal 180 Trying 1st = 3 mo 2nd = 6mo 3rd = 1yr GW 180
Dec 5, 2011 VSG, 5'7" Male, HW 320, SW 276, CW 235, GW 190
Loss by Doc Visit 1mo=18 3mo= 26 6mo=??
Curious whaqt kind of snafu? Mine I think the ins co threw away the original ppwrk. Was sent for lapband but after correcting the Dr. Office they sent for VSG then got a letter stating they needed supporting documentation for medical necessity.
Waiting to hear back now as the documentation was resubmitted this morning.
thx
Waiting to hear back now as the documentation was resubmitted this morning.
thx
1st Goal 225 2nd Goal 200 3rd Goal 180 Trying 1st = 3 mo 2nd = 6mo 3rd = 1yr GW 180
Dec 5, 2011 VSG, 5'7" Male, HW 320, SW 276, CW 235, GW 190
Loss by Doc Visit 1mo=18 3mo= 26 6mo=??
It was a miscommunication between departments in the insurance company. I had to call earlier today because I got double-billed for something by my PCP unrelated to the surgery. While I was on the phone, I asked about the status of my approval. Last week, when I was at the surgeon's, they told me they had authorization for the surgery but insurance had approved the RnY. I had the name of the person I had talked to when I had asked if VSG was covered, the date, and the time, and gave that to the surgeon's office. They didn't seem all that concerned that it was something major, and with the holiday, I didn't worry when I didn't hear back from them after they called to tell me the insurance wouldn't consider it until I had my EKG done (which was submitted last Monday).
So my jaw dropped when the insurance rep told me that my request was denied and VSG was not a covered benefit. She told me the only thing I could do was file an appeal, which would be reviewed by my health trust group, and they weren't bound by the 30-day guidelines. I had a nice little freak out, but then called the surgeon's office. The surgeon's insurance coordinator had my authorization letter on her desk as I called, and she called back to the insurance for me. She called me back and said it was a miscommunication between the benefits and the pre-cert departments, but she had an authorization letter for VSG and all I have to do now is set up my pre-surgical interview and get my bloodwork done - and start the liquid diet on the 7th.
Hopefully you hear back very soon with good news!
So my jaw dropped when the insurance rep told me that my request was denied and VSG was not a covered benefit. She told me the only thing I could do was file an appeal, which would be reviewed by my health trust group, and they weren't bound by the 30-day guidelines. I had a nice little freak out, but then called the surgeon's office. The surgeon's insurance coordinator had my authorization letter on her desk as I called, and she called back to the insurance for me. She called me back and said it was a miscommunication between the benefits and the pre-cert departments, but she had an authorization letter for VSG and all I have to do now is set up my pre-surgical interview and get my bloodwork done - and start the liquid diet on the 7th.
Hopefully you hear back very soon with good news!
-Kristi
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